Urged to abort her baby, Kristina Davis instead puts her faith in God
"There's no chance for your baby to survive."
For the third time in less than 48 hours, Kristina and Charles Davis faced the possibility of aborting their child, a little girl they have named Johanna. The day before, they discovered that Johanna was healthy at about 20 weeks into Kristina's pregnancy. But the ultrasound also revealed an unusual thickness near Kristina's cervix - Johanna was sharing space with a tumor, and doctors couldn't tell how aggressive the cancer was.
Twice before, Kristina and her family prayed for guidance, and twice her doctors came back with new information that put on hold theneed to abort Johanna. But now a top specialist in the field of gynecological cancers told Kristina that she may not survive the pregnancy.
"They were afraid that if I survive the pregnancy, (the cancer) would have spread too far," Kristina said. "She goes, 'Your only options right now would be for us to do a C-section and (abort) your baby or to start radiation, which would kill the baby.' To me, I'm not poisoning my child and I'm not authorizing you to do a procedure, so I didn't know what to do."
'I just felt pregnant..."
Kristina and Charles Davis live in Crescent City, raising their two boys, Gabe, 10 years old, and Little Charley, who is 15 months old.
Kristina grew up in Crescent City, winning track and field championships at Del Norte High School and working at Safeway since 16. She left for the University of California, Davis, but returned home at the end of her freshman year when a car accident left her with a broken back.
Kristina recovered from her injuries and graduated from College of the Redwoods. She still worked the checkout stand at Safeway in February when the bleeding started.
"I was at work, and I just started gushing blood. The blood clots were horrible," Kristina said. "So we rushed to the hospital and they said, 'You've had a miscarriage.'"
That was on Feb. 8. A pregnancy test came back positive, but when doctors did an ultrasound they couldn't see a baby. Kristina said doctors saw debris in her uterus near the cervix that they thought was leftover pregnancy tissue.
When she visited her obstetrician in Medford on March 3, Kristina said the doctor told her she had a miscarriage. An ultrasound showed the same debris Sutter Coast doctors saw a month earlier. A month later when Kristina's obstetrician saw the debris, he told her that it was pregnancy tissue he wanted to let pass naturally.
Kristina disagreed with her obstetrician. She'd had miscarriages before, and she had a difficult time delivering Little Charley, who was born a month early.
"I just felt pregnant still, and I'm like, 'It's either that or it's the hormones because we had miscarriages before,'" she said. "This one's different. And the bleeding never stopped."
On March 26 Kristina returned to her obstetrician. She was in pain and exhausted, and she was still bleeding. Her doctor drew blood and found her pregnancy hormone level to be high for someone who wasn't pregnant.
Another ultrasound later and Kristina and Charles were introduced to their daughter. Kristina was about 10 weeks pregnant, and the baby was healthy. She said her doctor told her that she was bleeding because there was a small tear in her uterus.
Despite the complications, she and Charles were relieved to have a reason for the pain and bleeding, she said.
But the bleeding never stopped. She kept getting weaker and had pain in her lower back and abdomen. Ten days after she found out she was pregnant, her doctor put her on bed rest.
"They said it was called a threatened miscarriage because anything before 20 weeks is considered a threatened miscarriage if you have bleeding during pregnancy," she said.
'Until there is no heartbeat'
Kristina felt what she thought were labor pains on June 1. She and Charles headed to Medford that night.
The next morning, Kristina's obstetrician performed a pelvic exam and was alarmed by her level of bleeding.
"He was like, 'This baby's not going to make it.' He's pushing the panic button in the room, and at that point my heart drops, my husband's heart drops - we don't know what's going on," she said. "The very first thing I said is, 'I don't believe we're having the baby right now,' and I said I would not authorize a procedure to deliver this baby until there was no heartbeat."
Kristina was rushed to the birthing center at Rogue Valley Medical Center. Her doctor initially thought her baby was being born breached, but later, Kristina said, he realized he was feeling the tumor. Doctors told her that they couldn't deliver her baby.
"They said, 'Your baby's healthy. Your baby's not going to be born right now," Kristina said, adding that they did another ultrasound, this one lasting about 45 minutes. "They checked everything with the baby (and said) there's absolutely nothing wrong with her. She's perfect. We found out it's a little girl, and her name's Johanna."
By this point, Kristina was halfway into her pregnancy. The same exam that showed Johanna was healthy also revealed the tumor. Doctors did a biopsy, came back in the room and told her she had cancer.
"They said, 'You're going to have to make the hard decisions on whether you keep this pregnancy or you survive," Kristina said, adding that Rogue Valley's head of the neonatal unit, Dr. Bryan Sohl, was called. "He said, 'If you choose to keep this pregnancy it will probably kill you and the baby.' They didn't know how aggressive the cancer was. I remember telling them 'No, I won't authorize that. I want to know more.'"
Kristina and Charles called their parents and their pastor at The Refuge Christian Fellowship and prayed. Kristina explained that her family is very strong in their Christian beliefs and abortion wasn't an option for them.
"When (we were) praying, there was this sense of peace I don't think any of us felt in the room before," she said. "We knew that God was right there and it was going to be OK. Half an hour after the pastor left, the high-risk OB came back in (and said), 'We want to send you to Portland.'"
Kristina said her OB had researched her situation and found anecdotal evidence of women who were diagnosed with cervical cancer while pregnant and went on to deliver healthy babies while being treated with chemotherapy.
The next day, Kristina met with Dr. Tanja Pejovic, a gynecology oncologist at Oregon Health and Science University, who again told her the cancer needed to be treated with radiation, which would poison her baby.
Kristina said Pejovic urged her to think of her boys and added that she could be carrying her child not knowing whether she was risking her own life in the meantime.
Again Kristina and her family prayed, and about 10 minutes later, Pejovic came back with new information.
"She goes, 'It is not possible to deliver your baby right now,'" Kristina said. "If they were to do a C-section and deliver the child, the tumor is so large and the risk of it spreading into my blood is so high that it would more than likely kill me."
Kristina said Pejovic informed her that radiation wasn't an option either. If the radiation didn't shrink the tumor enough to unblock Kristina's cervix and wound up killing Johanna, that could put Kristina's own life at risk. Once the baby miscarries it has to come out, Kristina said, but the tumor was barring the way.
"At that point we're ecstatic. I said, 'I want to start chemo; let's do it,'" she said. "There was literally, absolutely no hope. We prayed and then there was hope."
Kristina and Charles flew to Portland and OHSU's Knight Cancer Institute the next day.
Doctors diagnosed Kristina with stage 2B cervical adenocarcinoma. The tumor was found high in Kristina's cervix and went undetected by a recent pap smear.
Cervical cancer is the most common gynecological cancer worldwide, and it's one of the most common cancers diagnosed during pregnancy, said Dr. Koen De Geest, who is one of a team of gynecology oncologists and other doctors treating Kristina at OHSU.
Even though it's less common than squamous cell carcinoma of the cervix, which generally occurs near the vagina, doctors can effectively treat cervical adenocarcinoma with chemotherapy and radiation, De Geest said.
"Adenocarcinoma can occur at all ages," he said. "There are two different cell types, but the treatment is the same."
Cancers that occur high in the cervical canal often aren't caught until they reach a more advanced stage, De Geest said. Some cancers can have a detrimental affect on a fetus, he said, but cervical cancer typically doesn't. The only adverse effect occurs due to the treatment of the cancer, De Geest said.
Chemotherapy has been used for a variety of cancers during pregnancy and has had "fairly good outcomes," De Geest said. But both chemo and radiation are toxic.
"The general recommendation for treatment has usually been to terminate the pregnancy and try to save the life of the mother," he said. "Another option that exists is not to terminate the pregnancy, but to give radiation and chemotherapy, which would result in either fetal demise or severe fetal compromise that may lead to death later on."
'What we can do best'
De Geest said what makes Kristina's case unusual isn't the cancer or the fact that she's pregnant. It's her steadfast refusal to potentially harm her baby by accepting radiation treatment.
"What we learn is that decisions with respect to cancer treatment and pregnancy are always difficult," he said. "By definition, this is different from treating breast cancer or melanoma or lymphoma or leukemia in the pregnancy, because here the treatment has to be targeted to the very organ where the fetus lives."
Kristina, De Geest said, was counseled by physicians specializing in gynecology oncology, neonatal medicine and obstetrics. But she never wavered. She was never "wishy-washy," he said.
So far, treating the cancer with only chemotherapy seems to be working, but doctors can't determine what Kristina's long-term survival will be like, De Geest said.
Kristina could safely deliver Johanna and then receive radiation therapy, De Geest said. But adverse effects of the cancer could linger for one or two years after treatment.
De Geest said doctors are waiting until Kristina's pregnancy reaches 32 weeks before they try to deliver Johanna by C-section. By that point, he said, doctors hope Johanna's lungs and growth will be sufficiently matured. A normal pregnancy lasts about 40 weeks.
"What we can do best as physicians is to listen to what Mrs. Davis has to say," De Geest said. "She has had a lot of input but has steadily kept to a course, which has always been clear in her mind, and we support her in that."
'A real person'
Laverne Abernathy made her first attempt at creating a Facebook page the day she found out her daughter had cancer. Her husband, Keith Abernathy, trying to wrap his head around the cost of Kristina's treatment, called a buddy from work, Morris Eggen, and began coming up with fundraising ideas.
"Never did we feel that we would be on the receiving end, to be in a position where you had to reach out for help," Keith said.
Laverne said she and Kristina had been following the Facebook page of a local family whose baby was born premature and saw how much support the family received. The words of encouragement and prayer uplifted the family and appeared to have a positive effect on the baby, Laverne said.
Finding out that Kristina was pregnant with a baby girl and she had cervical cancer was a double whammy, Laverne said. When she returned home, she decided people needed to be aware of Kristina's situation.
"The more support she could possibly get from this, as far as encouragement, might help keep her going, keep her motivated," Laverne said. "I told her I would put the baby's name on the page and hers and her husband's name if that was OK. The baby was a real person. That was the way I felt. She needed to look at that to keep going."
The Facebook page, "Prayers for Baby Johanna and her parents Kristina and Charley," currently has 416 members. Kristina and her parents use it to keep folks up to date and to announce the raffles and other fundraisers they are doing.
One fundraiser that 10-year-old Gabe Davis came up with was a raffle of 500 bricks of .22 ammunition, which he says is difficult to find. The ammunition was on display at Full Metal Armor in Crescent City.
"Grandpa's friend Morris helped set up the fundraiser," Gabe said. "We're trying for all the raffle tickets to raise $7,000."
The ammunition raffle generated about $1,700, Keith Abernathy said. Another raffle, of a Savage rifle, brought $3,700. Abernathy said he and his friends are currently raffling off a jewelry set donated by Harbrook Jewelers in Brookings.
Another fundraising effort was initiated by one of Kristina's customers, Ron Mayhue, on FundRazr.com . That effort has raised $4,050 so far.
"I never personally met him before, and I still haven't met him, but he contacted me and said, 'I feel called to do this,'" she said. "It's amazing. I have received probably hundreds if not thousands of messages from Facebook from people telling me that they've heard my story and it's inspired them."
Kristina and her family will also be at today's Relay For Life, Abernathy said.
A gift from God
Despite the cancer, Kristina and Charles are excited that they're having their first baby girl. They began buying preemie clothes and say they know Johanna is going to make it.
Kristina has gone through two rounds of chemotherapy, and even though it's too soon to tell whether the tumor has gotten smaller, Johanna continues to develop normally. As soon as Johanna is safely delivered, Kristina will start radiation to eradicate the cancer.
When they found out Kristina was pregnant, she and Charles each picked out a name. Kristina said she chose Matthew and Charles chose Johanna. Both mean "a gift from God."
Since she was diagnosed with cancer, Kristina said she has been inspired and uplifted by the support from the community. One woman even donated $2,000 online, Kristina said, and told her it was "God's gift to us."
Once she gets through the pregnancy and cancer treatment, Kristina said, she will pass on the love she's received to others going through similar situations. She said she will encourage women to get screened for cancer.
But one thing Kristina can't wait to do is see her little girl and tell her about what they went through together, Kristinasaid.
"Essentially she's saving my life right now as much as I'm saving hers."
Reach Jessica Cejnar at firstname.lastname@example.org .